Active NPI
Adi Tova Wyshogrod
- Registered Dietitian
- Worcester, MA
National Provider Identifier
1619449899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86110390
- Practice address
- 49 Barry Rd
Worcester, MA 01609-1138 - Phone
- (508) 736-5453
- NPI assigned
- Dec 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86110390 | CA | Primary |
Addresses
Primary practice location
49 Barry Rd
Worcester, MA 01609-1138
Mailing address
265 Chelmsford St Ste 7
Chelmsford, MA 01824-2335
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86110390 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hayl Nutrition & Wellness | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1619449899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 CHELMSFORD ST STE 7",
"city": "CHELMSFORD",
"state": "MA",
"postal_code": "018242335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 BARRY RD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016091138",
"telephone_number": "508-736-5453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYSHOGROD",
"first_name": "ADI",
"middle_name": "TOVA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-27",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86110390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.